Extended arch resection in acute type A aortic dissection: CON

Abstract

Acute type A dissection is one of the most lethal conditions that surgeons encounter. Advances in surgical techniques and perioperative management have resulted in acceptable short- and long-term outcomes. Traditionally, the surgical approach involves a conservative extent of aortic arch resection. Recently, some groups have advocated a more aggressive approach wherein the entire aortic arch is replaced or an adjuvant descending aortic stent graft placed. This article reviews the literature pertaining to extent of distal aortic replacement in acute type A aortic dissection, arguing that a conservative approach is associated with more favorable outcome.